Master Cleanse redux

I am extremely pleased to find that my Master Cleanse blog has created controversy and debate. This is what this public forum is intended to provide. I supply essays on both controversial and non-controversial topics and readers reply with their experience and everyone can read all the posts and take away what they want. So far there have been nearly 2000 page views for this particular blog, and I find it encouraging that people out there in cyberspace are reading my entries. I certainly have stirred up a hornet’s nest with this story, and there seem to be comments both for and against my opinions. I welcome dissenting views. In this regard, please also see the important note at the end of this piece.

A variety of concerns have been expressed. One is that I was trained as an allopathic physician. This is true and therefore I have a certain bias towards that teaching. I encourage people to take this into account when reading my entries. However, I do not have an inherent bias against natural products or remedies. I do have a bias against scientific claims without scientific evidence. I do have a bias against reports of individuals for a variety of reasons (please do not take this to mean that I deny anyone’s experience, but I would not want to make medical decisions based on individual reports). First, an individual’s report is limited to their personal experience and does not provide balancing information for the experience of many others who have not written in with comments. Second, an individual’s report is potentially biased due to the placebo effect that I discussed elsewhere. The way that scientists get around these problems is to do studies. In these studies, a sufficient number of people are tested so that predictions can be made for the population as a whole. Depending on what you are studying, this often requires several hundred people in order to eliminate any bias from individual reports.

The other thing that these studies do is to randomly assign the study subjects into groups so that neither the doctor nor the patient can influence the group to which the patient is assigned. Moreover, in addition to randomly assigning the patients to different groups, neither the doctor nor the patient know what treatment is being given (i.e., active drug or placebo). All these steps are taken to eliminate individual bias and to allow for true comparisons between groups.

One of the biggest problems with most of the natural products and remedies is the lack of rigorous clinical studies. While it is true that the pharmaceutical industry may not be interested in such studies, the makers and marketers of the natural products should be. So it is they who should bear the fault for not undertaking such studies. Just as a lot of money is made by pharmaceutical companies, so too is a lot of money made by natural product and remedy companies. The lack of study data is at the heart of this discussion. Yes, pharmaceutical companies want to make money and get new products approved. But they are required to undertake extremely rigorous clinical trials, that have testable hypotheses and the results of which are published for the world to consider. Why is it then that the natural remedy industry does not undertake such studies? While the pharmaceutical company/FDA interaction may not be perfect, at least there is an attempt at science. You will almost never find a natural remedy company doing such studies for, I believe, a variety of reasons. First, there is no legal requirement. Second, and this is my personal opinion, they know full well that their studies will come up empty. If they could provide verifiable data, it seems to me that it would be in their best interest to do so. Imagine the difference between a claim made with no data, and one made with true scientific back-up. I’d think that more people would buy the product with the data and this would give the company a competitive advantage.

Let’s now turn to the question of who is making money off Master Cleanse? If one Googles Master Cleanse, you will find many, many websites offering products, books, tapes, CDs, DVDs and kits containing everything you need to undertake the program. Just go to Amazon.com and enter Master Cleanse and see how many people are making money off this idea. So clearly there is a lot of money being made here, which, in my opinion, is the driving force behind such programs.

A comment has been offered to the effect that my background in the pharmaceutical industry renders my opinions questionable if not valueless. In regard to Master Cleanse, I did not suggest that pharmaceutical products be purchased. I recommended lifestyle changes. Eat a little less and exercise a little more. I have repeated this advice in several of my blogs. No one is making money off of that recommendation. HealthTalk is not in the business of selling anything. All our programs are free as is our entire Web site. There may be product advertising on our site, but any company is free to purchase such ad space. We do not endorse or otherwise recommend any such advertised products. Our mission at HealthTalk is to provide unbiased, sound medical information that can empower patients to make better decisions for themselves. I believe it is important to provide negative as well as positive information. Negative information, for example, would be to inform people that there have been no studies done on the Master Cleanse program. Such information might be useful to people considering such a program. There is plenty of “positive” information on the internet about the alleged benefits of the program and I was attempting to provide some balance.

Yes I have worked in the pharmaceutical industry. But my blogs are based on studies and data or the lack thereof. I attempt to report on important topics that have been subject to scientific study. I have also noted, when appropriate, that the scientific evidence is not yet robust enough to make any recommendations. Or that the studies are preliminary and have not been verified. I feel this type of negative information is important to cut through some of the media hype around news. I give you more than a sound-bite.

I will certainly not dispute the fact that I am an allopath and not a naturopath. There are other Web sites where naturopaths and other alternative care practitioners can promulgate their information. I will always strive for science over rumor and anecdote. If there are positive studies on natural remedies I will report on them; I’d be overjoyed to obtain such data.

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ABOUT THE AUTHOR

Ed Zimney, MD

Ed is a physician with more than 30 years of experience. He’s held positions in drug advertising review, drug safety surveillance, medical information and marketing with several bio/pharmaceutical companies.

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